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Mi T, Qiu Z, Li C, Li W, Gao Y, Chen Z, Xu W, Liu Z, Li Q, Jiang M, Liu H, Dai L, Zhan Y. Joint effects of green space and air pollutant exposure on preterm birth: evidence from a nationwide study in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:35149-35160. [PMID: 38727972 DOI: 10.1007/s11356-024-33561-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 04/30/2024] [Indexed: 05/30/2024]
Abstract
An association between green space exposure and preterm birth has been reported. However, evidence on the joint effects of air pollutant and green space exposure on preterm birth from nationwide research is limited in China. Based on a nationwide cohort, this study aims to explore the effect of green space exposure on preterm birth and analyze the joint effects of green space and air pollutant. Logistic regression models were developed to analyze the effects of green space exposure, and interaction effects were evaluated by adding interaction terms between green space and air pollutants. From 2013 to 2019, this study included 2,294,188 records of newborn births, of which 82,921 were preterm births. The results show that for buffer zones with 250 m, 500 m, 1000 m, and 1500 m, every 0.1 unit increase in NDVI exposure was associated with a decrease in the risk of preterm birth by 5.5% (95% CI: 4.6-6.4%), 5.8% (95% CI: 4.9-6.6%), 6.1% (95% CI: 5.3-7.0%), and 5.6% (95% CI: 4.7-6.5%), respectively. Under high-level exposure to air pollutants, high-level NDVI exposure was more strongly negatively correlated with preterm birth than low-level NDVI exposure. High-level green space exposure might mitigate the adverse effect of air pollutants on preterm birth by promoting physical activity, reducing stress, and adsorbing pollutants. Further investigation is needed to explore how green space and air pollution interact and affect preterm birth, in order to improve risk management and provide a reference for newborn health.
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Affiliation(s)
- Tan Mi
- College of Carbon Neutrality Future Technology, Sichuan University, Chengdu, 610065, Sichuan, China
| | - Zhimei Qiu
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, 610065, Sichuan, China
- The Joint Laboratory for Pulmonary Development and Related Diseases, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Chunyuan Li
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, 610065, Sichuan, China
| | - Wenyan Li
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Yuyang Gao
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Zhiyu Chen
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Wenli Xu
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Zhen Liu
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Qi Li
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
| | - Min Jiang
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Hanmin Liu
- The Joint Laboratory for Pulmonary Development and Related Diseases, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- NHC Key Laboratory of Chronobology, Sichuan University, Chengdu, 610041, Sichuan, China
- Med-X Center for Informatics, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Li Dai
- The Joint Laboratory for Pulmonary Development and Related Diseases, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, Sichuan, China
- NHC Key Laboratory of Chronobology, Sichuan University, Chengdu, 610041, Sichuan, China
- Med-X Center for Informatics, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yu Zhan
- College of Carbon Neutrality Future Technology, Sichuan University, Chengdu, 610065, Sichuan, China.
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Yu Y, Lin H, Liu Q, Ma Y, Zhao L, Li W, Zhou Y, Byun HM, Li P, Li C, Sun C, Chen X, Liu Z, Dong W, Chen L, Deng F, Wu S, Hou S, Guo L. Association of residential greenness, air pollution with adverse birth outcomes: Results from 61,762 mother‑neonatal pairs in project ELEFANT (2011-2021). THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:169549. [PMID: 38145684 DOI: 10.1016/j.scitotenv.2023.169549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/06/2023] [Accepted: 12/18/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Emerging evidence has demonstrated the benefits of greenness exposure on human health, while conflicts remain unsolved in issue of adverse birth outcomes. METHODS Utilizing data from project ELEFANT spanning the years 2011 to 2021, we assessed residential greenness using the NDVI from MODIS data and residential PM2.5 exposure level from CHAP data. Our primary concerns were PTD, LBW, LGA, and SGA. Cox proportional hazard regression model was used to examine the association of residential greenness and air pollution exposure with risk of adverse birth outcomes. We performed mediation and modification effect analyses between greenness and air pollutant. RESULTS We identified 61,762 mother‑neonatal pairs in final analysis. For per 10 μg/m3 increase in PM2.5 concentration during entire pregnancy was associated with 19.8 % and 20.7 % increased risk of PTD and LGA. In contrast, we identified that an 0.1 unit increment in NDVI were associated with 24 %, 43 %, 26.5 %, and 39.5 % lower risk for PTD, LBW, LGA, and SGA, respectively. According to mediation analysis, NDVI mediated 7.70 % and 7.89 % of the associations between PM2.5 and PTD and LGA. Residential greenness could reduce the risk of PTD among mothers under 35 years old, living in rural areas, primigravidae and primiparity.. CONCLUSIONS In summary, our results highlighted the potential of residential greenness to mitigate the risk of adverse birth outcomes, while also pointing to the adverse impact of PM2.5 on increased risk of multiple adverse birth outcomes (PTD and LGA). The significant mediation effect of NDVI emphasizes its potential as an important protective factor of PM2.5 exposure. Additionally, the identification of susceptible subgroups can inform targeted interventions to reduce adverse birth outcomes related to air pollution and lack of green spaces. Further research and understanding of these associations can contribute to better public health strategies aimed at promoting healthier pregnancies and birth outcomes.
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Affiliation(s)
- Yuanyuan Yu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Huishu Lin
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Qisijing Liu
- Research Institute of Public Health, School of Medicine, Nankai University, Tianjin, China
| | - Yuxuan Ma
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Lei Zhao
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Weixia Li
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Yan Zhou
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin 300072, China
| | - Hyang-Min Byun
- Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne NE4 5PL, UK
| | - Penghui Li
- Department of Environmental Science, School of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin, China
| | - Chen Li
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Congcong Sun
- Department of Scientific Research Center, The Third Clinical Institute Affiliated of Wenzhou Medical University, The Third Affiliated of Shanghai University, Wenzhou People's Hospital, Wenzhou Maternal and Child Health Care Hospital, Wenzhou, China
| | - Xuemei Chen
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Ziquan Liu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China
| | - Wenlong Dong
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China
| | - Liqun Chen
- Academy of Medical Engineering and Translational Medicine, Medical College, Tianjin University, Tianjin 300072, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Shike Hou
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China.
| | - Liqiong Guo
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin 300072, China; Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou 325000, China; Tianjin Key Laboratory of Disaster Medicine Technology, Tianjin, China.
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Ye T, Xu R, Abramson MJ, Guo Y, Zhang Y, Saldiva PHN, Coelho MSZS, Li S. Maternal greenness exposure and preterm birth in Brazil: A nationwide birth cohort study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 343:123156. [PMID: 38142032 DOI: 10.1016/j.envpol.2023.123156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/25/2023]
Abstract
In the dynamic landscape of maternal and child health, understanding the intricate interplay between environmental factors and pregnancy outcomes is of paramount importance. This study investigates the relationship between maternal greenness exposure and preterm births in Brazil using data spanning from 2010 to 2019. Satellite-derived indices, including the Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), were employed to assess greenness exposure during whole pregnancy in maternal residential area. Employing Cox proportional hazard models, we calculated the hazard ratios (HRs) with 95% confidence intervals (CIs) for changes in NDVI, while adjusting for individual and area-level covariates. In total, 24,010,250 live births were included. Prevalence of preterm birth was 11.5%, with a modest but statistically significant decreasing trend (p = 0.013) observed across the nation over the study period. The findings reveal a significant association between greenness exposure and a reduced risk of preterm birth. Specifically, for every 0.1 increase in NDVI, there was a 2.0% decrease in the risk of preterm birth (95%CI: 1.9%-2.2%). Stratified analyses based on maternal education and ethnicity indicated potential effect modifications, with stronger protective effects observed among younger mothers and those with less years of education. Sensitivity analyses using EVI yielded consistent results. In conclusion, this study suggests that higher maternal greenness exposure is linked to a decreased risk of preterm birth in Brazil. These findings imply that enhancing residential greenspaces could be a valuable public health strategy to promote maternal and child health in Brazil.
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Affiliation(s)
- Tingting Ye
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Rongbin Xu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Michael J Abramson
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Yiwen Zhang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Paulo H N Saldiva
- Urban Health Laboratory University of São Paulo, Faculty of Medicine/INSPER, São Paulo, 01246-903, Brazil
| | - Micheline S Z S Coelho
- Urban Health Laboratory University of São Paulo, Faculty of Medicine/INSPER, São Paulo, 01246-903, Brazil
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
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Jiang W, Wang C, Zhang Q, Zeng X, Kan H, Zhang J. Residential greenspace counteracts PM 2.5 on the risks of preterm birth subtypes: A multicenter study. CHEMOSPHERE 2023; 340:139917. [PMID: 37611762 DOI: 10.1016/j.chemosphere.2023.139917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND The association between residential greenspace and preterm birth (PTB) risk remained inconclusive. The PTB subtypes have been ignored and the effect of co-exposure of PM2.5 on PTB risk is still unclear. OBJECTIVE To investigate the independent, interactive, and mixed effects of residential greenspace and PM2.5 on the risk of PTB subtypes. METHODS A total of 19,900 singleton births from 20 hospitals in Shanghai, China, from 2015 to 2017 were included. The Normalized Difference Vegetation Index (NDVI) within 500 m and 1000 m buffers of the maternal residence and a combined geoscience-statistical model-derived PM2.5 and its six components were used as the exposure measures. PTB (<37 completed weeks of gestation) were divided into early PTB (24-33 weeks) vs. late PTB (34-36 weeks) and into spontaneous PTB (sPTB), preterm premature rupture of the fetal membranes (PPROM), and iatrogenic PTB. Multivariable logistic regression models were applied to assess the independent and interactive effects of NDVI and PM2.5 on PTB in each trimester. The quantile g-computation approach was employed to explore the mixture effect of PM2.5 components and greenspace across the pregnancy and to determine the main contributors. RESULTS Levels of PM2.5 and greenspace were associated with increased [aOR (95%CI) ranging from 1.18 (1.07, 1.30) to 3.36 (2.45, 4.64)] and decreased risks [aORs (95%CI) ranging from 0.64 (0.53, 0.78) to 0.86 (0.73, 0.99)] of PTB subtypes, respectively. At the same PM2.5 level, higher residential greenspace was associated with lower risks, and vice versa. All these associations were more pronounced in late pregnancy. Early PTB and PPROM were the main affected subtypes, and the main drivers in PM2.5 were black carbon and ammonium. CONCLUSIONS Residential greenspace may mitigate the PTB risks due to PM2.5 exposure during pregnancy.
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Affiliation(s)
- Wen Jiang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Cuiping Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Qingli Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China; School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Xiaojing Zeng
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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Gailey S. Changes in Residential Greenspace and Birth Outcomes among Siblings: Differences by Maternal Race. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6790. [PMID: 37754649 PMCID: PMC10531468 DOI: 10.3390/ijerph20186790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/06/2023] [Accepted: 08/19/2023] [Indexed: 09/28/2023]
Abstract
Growing research investigates the perinatal health benefits of greenspace in a mother's prenatal environment. However, evidence of associations between residential greenspace and birth outcomes remains mixed, limiting the relevance this work holds for urban policy and greening interventions. Past research relies predominantly on cross-sectional designs that are vulnerable to residential selection bias, and rarely tests effect modification by maternal race/ethnicity, which may contribute to heterogeneous findings. This study uses a rigorous, longitudinal sibling comparison design and maternal fixed effect analyses to test whether increases in maternal exposure to residential greenspace between pregnancies precede improved birth outcomes among non-Hispanic (NH) white (n = 247,285) and Black (n = 54,995) mothers (mean age = 28 years) who had at least two consecutive live births in California between 2005 and 2015. Results show that increases in residential greenspace correspond with higher birthweight (coef. = 75.49, 95% CI: 23.48, 127.50) among Black, but not white (coef. = -0.51, 95% CI: -22.90, 21.90), infants. Additional analyses suggest that prior evidence of perinatal benefits associated with residential greenspace among white mothers may arise from residential selection; no such bias is observed for Black mothers. Taken together, these findings support urban greening initiatives in historically under-resourced neighborhoods. Efforts to evenly distribute residential greenspace may reduce persistent racial disparities in birth outcomes, an important step towards promoting health equity across the life course.
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Affiliation(s)
- Samantha Gailey
- Department of Forestry, Michigan State University, East Lansing, MI 48824, USA;
- Department of Public Health, Michigan State University, Flint, MI 48502, USA
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Siddika N, Song S, Margerison CE, Kramer MR, Luo Z. The impact of place-based contextual social and environmental determinants on preterm birth: A systematic review of the empirical evidence. Health Place 2023; 83:103082. [PMID: 37473634 DOI: 10.1016/j.healthplace.2023.103082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/22/2023]
Abstract
The objective of this study was to systematically review the available empirical evidence examining associations between preterm birth (PTB) and five domains of place-based contextual social and environmental determinants, including (1) physical environment, (2) residential greenness, (3) neighborhood violence/crime, (4) food accessibility and availability, and (5) health services accessibility, among adult mothers in high-income countries. The evidence in this review suggests an adverse association between damaged physical environment, neighborhood violence/crime, lack of health services accessibility, and PTB. The existing evidence also suggests a beneficial effect of residential greenness on PTB. Further studies are needed to investigate these associations for more understanding of the direction and magnitude of these association and for potential heterogeneity by factors such as race/ethnicity, urban vs rural residence, immigration status, and social class.
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Affiliation(s)
- Nazeeba Siddika
- Department of Epidemiology and Biostatistics, Michigan State University, Fee Hall West Wing; 909 Wilson Rd, East Lansing, MI, 48824, USA
| | - Shengfang Song
- Department of Epidemiology and Biostatistics, Michigan State University, Fee Hall West Wing; 909 Wilson Rd, East Lansing, MI, 48824, USA
| | - Claire E Margerison
- Department of Epidemiology and Biostatistics, Michigan State University, Fee Hall West Wing; 909 Wilson Rd, East Lansing, MI, 48824, USA
| | - Michael R Kramer
- Department of Epidemiology, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
| | - Zhehui Luo
- Department of Epidemiology and Biostatistics, Michigan State University, Fee Hall West Wing; 909 Wilson Rd, East Lansing, MI, 48824, USA.
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Slawsky ED, Weaver AM, Luben TJ, Rappazzo KM. A cross-sectional study of brownfields and birth defects. Birth Defects Res 2022; 114:197-207. [PMID: 35182113 PMCID: PMC10867712 DOI: 10.1002/bdr2.1992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Brownfields are a multitude of abandoned and disused sites, spanning many former purposes. Brownfields represent a heterogenous yet ubiquitous exposure for many Americans, which may contain hazardous wastes and represent urban blight. Neonates and pregnant individuals are often sensitive to subtle environmental exposures. We evaluate whether residential brownfield exposure is associated with birth defects. METHODS Using North Carolina birth records from 2003 to 2015, we sampled 753,195 births with 39,495 defects identified. We examined defect groups and 30 distinct phenotypes. Number of brownfields within 2,000 m of the residential address at birth was summed. We utilized mixed effects multivariable logistic regression models adjusted for demographic and environmental covariates available from birth records, 2010 Census, and EPA's Environmental Quality Index to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS We observed positive associations between cardiovascular and external defect groups (OR [95% CI]: 1.07 [1.02-1.13] and 1.17 [1.01-1.35], respectively) and any brownfield exposure. We also observed positive associations with atrial septal and ventricular septal defects (1.08 [1.01-1.16] and 1.15 [1.03-1.28], respectively), congenital cataracts (1.38 [0.98-1.96]), and an inverse association with gastroschisis (0.74 [0.58-0.94]). Effect estimates for several additional defects were positive, though we observed null associations for most group and individual defects. Additional analyses indicated an exposure-response relationship for several defects across levels of brownfield exposure. CONCLUSIONS Our results indicate that residential proximity to brownfields is associated with birth defects, especially cardiovascular and external defects. In-depth analyses of individual defects and specific contaminants or brownfield sites may reveal additional novel associations.
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Affiliation(s)
- Erik D. Slawsky
- Oak Ridge Associated Universities at the US Environmental Protection Agency, Chapel Hill, North Carolina, USA
| | - Anne M. Weaver
- United States Environmental Protection Agency, RTP, North Carolina, USA
| | - Thomas J. Luben
- United States Environmental Protection Agency, RTP, North Carolina, USA
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Tvina A, Visser A, Walker SL, Tsaih SW, Zhou Y, Beyer K, Palatnik A. Residential proximity to tree canopy and preterm birth in Black women. Am J Obstet Gynecol MFM 2021; 3:100391. [PMID: 33984532 DOI: 10.1016/j.ajogmf.2021.100391] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND There are marked racial disparities in obstetrical outcomes, with the incidence of preterm birth being the highest among non-Hispanic Black women. The presence of green space, such as forests and parks, is now widely viewed as a health-promoting characteristic of residential environments. OBJECTIVE This study aimed to examine the association between the proximity of tree canopies to a prenatal residential address and the rates of preterm birth among non-Hispanic Black women in Milwaukee, Wisconsin. STUDY DESIGN This was a retrospective, case-control study utilizing hospital pregnancy records of self-identified non-Hispanic Black women. The addresses of the women, who delivered from 2011 to 2019, were geocoded to characterize the percentage of tree canopy surrounding the prenatal address using the National Land Cover Database. Circular residential buffers of 100, 150, 250, and 500 m were used to assess the exposure to tree canopy coverage in proximity to a prenatal address. Univariable and multivariable analyses were conducted to determine whether tree canopy percentage at 4 different proximity buffers, examined both in means and quartiles, was associated with preterm birth (birth at <37 weeks' gestation). RESULTS Of the 2771 non-Hispanic Black women included in the study, 333 (12.0%) experienced preterm births. Less tree canopy coverage was significantly (P < .05) associated with preterm birth, irrespective of whether the coverage was quantified as a mean or by quartile. In the unadjusted and adjusted models, which adjusted for sociodemographic and clinical risk factors for preterm birth, a 10% increase in tree canopy coverage was associated with lower odds of preterm birth at all 4 buffers examined. When examining the green space by quartile, higher quartiles were associated with lower odds of preterm birth at the 100-, 150-, and 250 m buffers, but not at the 500 m buffer. CONCLUSION A higher percentage of tree canopy coverage in close proximity to the prenatal residential address is associated with lower odds of preterm birth among non-Hispanic Black women. These findings suggest that access to neighborhood green space is an important factor associated with preterm birth.
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Affiliation(s)
- Alina Tvina
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI (Dr Tvina, MS Visser, and Dr Palatnik)
| | - Anna Visser
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI (Dr Tvina, MS Visser, and Dr Palatnik)
| | - Shannon L Walker
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI (Ms Walker and Dr Palatnik); Institute of Health and Equity, Department of Public and Community Health, Medical College of Wisconsin, Milwaukee, WI (Ms Walker and Drs Zhou and Beyer)
| | - Shirng-Wern Tsaih
- Genomic Sciences and Precision Medicine Center, Medical College of Wisconsin, Milwaukee, WI (Dr Tsaih)
| | - Yuhong Zhou
- Institute of Health and Equity, Department of Public and Community Health, Medical College of Wisconsin, Milwaukee, WI (Ms Walker and Drs Zhou and Beyer)
| | - Kirsten Beyer
- Institute of Health and Equity, Department of Public and Community Health, Medical College of Wisconsin, Milwaukee, WI (Ms Walker and Drs Zhou and Beyer)
| | - Anna Palatnik
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI (Dr Tvina, MS Visser, and Dr Palatnik); Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI (Ms Walker and Dr Palatnik).
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